Zim’s Aids Levy charms Uganda

Zimbabwe’s AIDS Levy has captivated Uganda which wants to copy the model as a way of coming up with own healthcare funding model.

Realising the massive contributions made by mobile network operators to the fiscus, Zimbabwe instituted a 5% tax on all mobile data and call charges, which goes straight into the Aids Levy to help combat HIV/Aids.

Uganda’s expression of copying Zimbabwe’s Aids Levy comes at a time when African nations are coming up with alternative healthcare funding models which are homegrown other than donor funding.

Speaking at the World Health Organisation’s first ever Africa Health Forum, Uganda’s Minister of State for Health Sarah Achieng Opendi revealed that they are planning for a decline in development assistance with Zimbabwe being the source of inspiration.

“Borrowing a leaf from Zimbabwe, we are now putting in place an HIV trust fund,” she said.

She added that they are working on making health insurance mandatory.

“We are also going to have an immunisation fund. These are some of the interventions we are putting in place. Not forgetting that we have to have our own health insurance scheme in place. Right now we are a finalising the bill in Parliament [to make mandatory health insurance happen],” said Opendi.

Meanwhile some of the deliberations at the Health Forum were that African countries are going to have to start footing their own medical bills.

“We are innovating new ways of financing apart from the budget and resources from development partners, because we know that development partners are declining,” said Claver Gatete, Rwanda’s finance minister.

World Bank research highlights the scale of this particular challenge. It shows that even though Africa’s health spend per capita has increased in the last 15 years, that increase was mainly driven by development assistance, and not government spending. Take donor funding away, and Africa risks losing the health gains made over the past decade – and stands no chance of introducing universal health care.

Gatete says that it is essential to find new ways to finance healthcare – and suggests that his country is a model worth following. Other delegates agree: although activists often raise concerns about Rwanda’s respect for human rights and question the authenticity of the government’s much-lauded development statistics, in this particular forum and on this particular issue there is only praise for Rwanda’s record.

Gatete says that a key factor in Rwanda’s success was the imposition of mandatory health insurance, with a government subsidy to help those who can’t afford it themselves. Another is performance incentives for medical facilities that receive government money, to ensure that it is spent effectively. “We know that you don’t simply provide money. We have to make sure that it’s results-based financing. We give certain benchmarks that hospitals must meet to provide money,” he said.

In the absence of donors, Rwanda is looking at how it can raise funds for this domestically, and is planning to issue a social-impact bond, said Gatete. Social impact bonds only pay out to investors once a certain social impact is achieved. Moreover, Gatete said that the interest generated by any capital raised through the bond would be directed specifically into healthcare.